Overall, the sample reported moderately high job satisfaction (M = 2.88, SD = 0.48) and moderate job stress (M = 2.09, SD = 0.55). Reports of job stress and satisfaction differed significantly by age, gender, marital status, educational attainment, labor force status, and type of work (). Older workers were more likely to report low job stress, regardless of job satisfaction, than younger workers (χ2 = 47.75, p < .001). Women were marginally more likely to report low job stress/low job satisfaction relative to men (χ2 = 6.78, p = .0791). Those in the high job strain category (high job stress/low job satisfaction; N = 1,039) were more likely to be employed full time (77.6%), working in a blue-collar occupation (28.0%), and had lower net worth relative to workers in the other job stress/satisfaction categories. Job stress and job satisfaction did not vary by race or smoking status. Participants who reported more depressive symptoms were more likely to be in the high job strain category (χ2 = 122.28, p < .001). There was no difference in reports of job stress or job satisfaction and moderate or heavy drinking (χ2 = 2.11, p = .550 and χ2 = 1.56, p = .668, respectively).
Respondent Characteristics by Strata of Job Strain, the Health and Retirement Study 2004/2006
In bivariate logistic regression analyses, the continuous measure of job stress was significantly associated with elevated depressive symptoms (odds ratio [OR]: 1.92, 95% confidence interval [CI]: 1.46–2.50, p < .001) but unrelated to alcohol misuse (OR: 0.93, 95% CI: 0.68–1.26, p = .621 for moderate drinking and OR: 1.26, 95% CI: 0.78–2.04, p = .342 for heavy drinking). Results were similar for the continuous measure of job satisfaction (OR: 0.45, 95% CI: 0.33–0.60, p < .001 for depression; OR: 0.77, 95% CI: 0.55–1.09, p = .145 for moderate drinking; and OR: 0.98, 95% CI: 0.57–1.68, p = .946 for heavy drinking). The categorical model of job strain that combined these two constructs further elucidated their relation to mental health. As shown in , the high levels of job strain were significantly associated with high depressive symptoms, an association that persisted after accounting for demographic characteristics, net worth, labor force status, occupation, and health behaviors. In the fully adjusted model, participants in the high job strain category (high job stress/low job satisfaction) had approximately three times the odds of high depressive symptoms relative to those in the low job strain (low job stress/high satisfaction) category (OR: 2.98, 95% CI: 1.99–4.45). Those in the high stress/high satisfaction category had lower, but still significantly elevated, risk of depression (OR: 1.93, 95% CI: 1.16–3.21) relative to the low stress/high satisfaction category. Finally, low job stress/low job satisfaction was associated with modestly elevated risk of depression (OR: 1.94, 95% CI: 1.23–3.05) relative to low stress/high satisfaction. Post hoc analyses of the relationship between job strain and the continuous measure of depressive symptoms were consistent with these findings, indicating that high job strain was associated with 0.68-point increase (95% CI: 0.53–0.83) in depressive symptoms relative to low job stress/high job satisfaction. Interaction terms between job strain and age group (≤65 vs. >65 years; p = .363) and gender (p = .351) were not significant and indicated that these relationships were similar for younger and older workers and for women and men.
Logistic Regression of the Association Between Job Strain and Depression Status
As shown in , there was no relationship between job strain and moderate drinking among those who drink in either the bivariate or fully adjusted models. Persons with white-collar occupations were less likely to be heavy drinkers relative to persons with blue-collar occupations. Similar results were observed for the heavy drinking outcome (see Supplementary Table 1
). There was no evidence of moderation by age group or gender. Additional analyses including nondrinkers in these models produced similar results.
Logistic Regression of the Association Between Job Strain and Moderate Alcohol Use
The analysis described earlier was restricted to adults who are currently employed, and thus, the potential bias introduced by the health worker survivor effect would be observed not from sicker workers exiting the labor force but rather from sicker workers leaving higher strain jobs for lower strain jobs. To address this potential bias, we further restricted the sample to workers who had been at their current job (in 2004/2006) for at least five years (N
= 1,765), and these analyses produced similar results (see Supplementary Tables 2
). Both the high job strain (OR: 2.24, p
= .001) and low job stress/low job satisfaction (OR: 1.76, p
= .05) categories were significantly associated with elevated depressive symptoms in the fully adjusted model. High job stress/high job satisfaction was not significantly associated with depression in this restricted sample (OR: 1.33, p
= .394), suggesting that the healthy survivor effect was largely restricted to workers with high job satisfaction. Consistent with , there was no relationship between job strain and moderate drinking (e.g., OR: 1.12, p
= .662 for high job strain) or heavy drinking.